Immunotherapy Combinations Improve Survival in Advanced Renal Cell Carcinoma

Bradley McGregor, MD, clinical director of Lank Center for Genitourinary Oncology, senior physician at Dana-Farber Cancer Institute, and instructor of Medicine at Harvard Medical School, discusses the current treatment landscape for patients with advanced or metastatic renal cell carcinoma (RCC), which has significantly evolved over the last few years.

RCC typically responds to judicial cytotoxic chemotherapy, then the first targeted therapies were introduced about 15 years ago, which included VEGF tyrosine kinase inhibitors (TKIs), McGregor says. The VEGF TKIs demonstrated improvements in progression-free survival and remained the mainstay of treatment for some time.

In 2017, the first data were presented that showed immunotherapy had a role in the frontline treatment of RCC, in particular nivolumab (Opdivo) improved overall survival and anemia compared with sunitinib (Sutent). Since then, McGregor says w have had other VEGF TKI/immunotherapy combinations approved by regulatory agencies, such as the axitinib (Inlyta) and pembrolizumab (Keytruda) and axitinib/avelumab (Bavencio) regimens.

There is a wide variety of treatment options now for patients with advanced or metastatic RCC, with TKI monotherapy being used less frequently given the new data for the combination regimens, which are now becoming standard of care given the survival benefits observed in this patient population.